Facility Evaluation Report

On 1/5/2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct an annual inspection. LPA was greeted by staff and allowed entrance into the facility. Licensee John Nobleza was already at the facility and LPA met with him.

Facility is licensed for 6 residents and has a current census of 6. Facility has 7 bedrooms, which includes 1 bedroom for live in staff, and 2.5 bathrooms. LPA observed the facility to be clean, odor free, and clutter free. All emergency exits are obstruction free. Fire extinguishers were last services on 7/18/2025 and have current charge. LPA checked the water temperature in the common bathroom which read at 109.9 degrees Fahrenheit. Smoke and carbon monoxide detectors are in working order.

LPA observed residents to each have their own rooms which are properly furnished with adequate lighting. LPA observed medications, knives, and cleaning/disinfectant supplies to be locked and inaccessible to residents in care. LPA observed 2-days worth of perishable food items and 7 days worth of non-perishable food items.

LPA reviewed resident files which are completed. LPA reviewed staff files which are current and up to date. LPA reviewed hospice care plans which are current and have proper training. LPA reviewed a sample of medication and did not find any medication errors. Centrally stored medication log was completed and accurate.

Exit interview was conducted and a copy of this report LIC809 was provided to Licensee John Nobleza.